A pharmacy strategy conference was held by Barking and Havering local pharmaceutical committee on January 30, 2000
There was a trap for the unwary in the concept of medicines management, said Professor Claire Mackie (head of the Aberdeen school of pharmacy).
The trap was to focus on the medicine rather than on the patient. Evidence of clinical effectiveness should not be limited to clinical outcomes, but should include improved quality of life. Compliance with treatment could be harmful if the initial therapeutic choice was wrong.
Improving outcomes through medicines management involved educating patients, their family members and carers, achieving compliance, optimising therapy and monitoring treatment.
Pharmaceutical care should embrace concordance, Professor Mackie went on. Concordance meant that clinical views were shared with the patient and the patient's health beliefs were shared with the clinician. Patients wanted a part in the selection of their treatment and practitioners should fully explain things. Ultimately, it was patients and their carers who managed medicines.
Turning to the prospects for pharmacist prescribing, Professor Mackie said that simply reclassifying prescription medicines as pharmacy medicines would lead to a two-tier system, where equity and access depended on ability to pay.
Many professional bodies agreed that pharmacists should be able to prescribe under the NHS for conditions which they already treated.
Repeat prescribing could be the most fruitful area for pharmacist involvement. Repeat prescribing accounted for 66 per cent by volume and 80 per cent by cost of the drugs bill. Benefits for patients included greater convenience and benefits for medical practices included saved resources. The risks of a lax system included poor disease control, adverse drug reactions, medicines waste and the continuance of treatment beyond the point of therapeutic benefit.
Concluding, Professor Mackie said that pharmacy faced a challenge. The present remuneration system would not sustain the profession into the new millennium. A contract needed to be made that met the professional, rather than the commercial, interests of the profession.
Other topics covered at the meeting |